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Intravesical therapy

Manuela Tutolo, Enrico Ammirati, Frank Van der Aa
Although both intravesical onabotulinumtoxinA injections and sacral neuromodulation could be offered in cases of bladder pain syndrome and overactive bladder syndrome, there is still no scientific agreement on the best option after failure of standard therapies.
March 15, 2018: European Urology Focus
Naotaka Nishiyama, Hiroshi Hotta, Atsushi Takahashi, Masahiro Yanase, Naoki Itoh, Hitoshi Tachiki, Noriomi Miyao, Masanori Matsukawa, Yasuharu Kunishima, Keisuke Taguchi, Hiroshi Kitamura, Naoya Masumori
OBJECTIVES: The aim of this study was to clarify the prognostic indicators for upper tract urothelial carcinoma (UTUC) following intravesical bacillus Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer (NMIBC). METHODS: Data from 402 patients who received intravesical BCG therapy between January 1990 and November 2011 were collected from 10 institutes. The median follow-up interval from transurethral resection of the bladder tumor (TURBT) followed by BCG treatment was 50...
March 14, 2018: Urologic Oncology
Beverley Greenwood-Van Meerveld, Ehsan Mohammadi, Rocco Latorre, Edward R Truitt, Gregory D Jay, Benjamin D Sullivan, Tannin A Schmidt, Nataliya Smith, Debra Saunders, Jadith Ziegler, Megan Lerner, Robert Hurst, Rheal A Towner
OBJECTIVE: To test in an animal model the hypothesis that rhPRG4 (lubricin), a highly O-glycosylated mucin-like glycoprotein, may be a novel surface-active therapeutic for treating bladder permeability with co-morbid bowel permeability. Previously we showed that inducing bladder permeability in rats with dilute protamine sulfate (PS) produced colonic permeability and visceral hypersensitivity, suggesting increased bladder permeability could represent an etiologic factor in both Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) and Irritable Bowel Syndrome (IBS)...
March 12, 2018: Urology
Suk Young Lee, Sang Hee Choi
Intravesical BCG therapy after transurethral resection of bladder tumor (TURB) is considered the most effective treatment for prophylaxis against the recurrence of high risk non-muscle invasive bladder cancer, and generally well tolerated and infectious complication are rare. We reported a case of granulomatous prostatitis is a patient who had undergone intravesical BCG therapy due to non-invasive superficial urothelial carcinoma of bladder. This patient was diagnosed by prostate biopsy because of PSA elevation without any other voiding symptoms and abnormal abscess pocket in transrectal ultrasonography...
March 2018: Urology Case Reports
Islam M El-Babouly, Esam A E Desoky, Diab El Sayed, Maged M Ali, Ola A Harb, Ahmed Ragab, Ahmed M Sakr, Amr M Fawzi, Nashaat M Salama, Ibrahim I Samaha
OBJECTIVE: To report the sensitivity and specificity of neural precursor cell-expressed developmentally down-regulated protein 9 (NEDD9) protein high expression in predicting BCG response and its effect on recurrence or progression free survivals. PATIENTS AND METHODS: Between May 2014 and April 2017, a prospective cohort study was conducted on 105 patients with intermediate or high-risk nonmuscle invasive bladder cancer. Immunohistochemical staining with mouse monoclonal anti-NEDD9 antibody was done...
March 5, 2018: Urologic Oncology
David D Andrea, Mohammad Abufaraj, Martin Susani, Robin Ristl, Beat Foerster, Shoji Kimura, Andrea Mari, Francesco Soria, Alberto Briganti, Pierre I Karakiewicz, Killian M Gust, Morgan Rouprêt, Shahrokh F Shariat
PURPOSE: To improve current prognostic models for the selection of patients with T1G3 urothelial bladder cancer who are more likely to fail intravesical therapy and progress to muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We performed a retrospective analysis of 1,289 patients with pT1G3 urothelial bladder cancer who were treated with transurethral resection of the bladder (TURB) and adjuvant intravesical bacillus-Calmette-Guérin (BCG). Random-split sample data and competing-risk regression were used to identify the independent impact of lymphovascular invasion (LVI) and variant histology (VH) on progression to MIBC...
March 2, 2018: Urologic Oncology
Johannes Falke, Christina A Hulsbergen-van de Kaa, Roberto Maj, Egbert Oosterwijk, Johannes Alfred Witjes
OBJECTIVES: To evaluate and compare the pharmacokinetic and pharmacodynamic properties of 2 investigational Toll-like receptor 7 agonists, TMX-101, and TMX-202 after intravenous and intravesical administration in a rat model. TLR-7 agonists are successfully used as topical treatment for various (pre)malignant skin lesions and are now under investigation as intravesical therapy for non-muscle-invasive bladder cancer. METHODS: Rats received an intravesical instillation with TMX-101, TMX-202, or vehicle...
February 27, 2018: Urologic Oncology
Siteng Chen, Ning Zhang, Jialiang Shao, Xiang Wang
BACKGROUND: It is not clear whether maintenance Bacillus Calmette-Guerin (BCG) is necessary for intermediate- or high-risk non-muscle-invasive bladder cancer (NMIBC). This systematic review and meta-analysis aimed to illustrate the effects of maintenance BCG for intermediate- or high-risk NMIBC. METHODS: A comprehensive literature search of PubMed, EMBASE, Cochrane Library, databases and International Clinical Trials Register (ICTRP) Search was conducted to identify relevant randomized controlled trials (RCTs) that have assessed the efficacy of maintenance or non-maintenance BCG therapy for patients with NMIBC...
February 28, 2018: International Journal of Surgery
Daniel Pelletier, Michael O'Donnell, Mary Seabury Stone, Vincent Liu
Patients treated with intravesical bacillus Calmette-Guerin therapy for urothelial carcinoma often become refractory and experience recurrent disease, thus necessitating alternative intravesical treatment modalities if the patient is to be spared the morbidities associated with radical cystectomy. Intravesical treatment with taxane-based chemotherapy, such as docetaxel, has gained traction in urologic oncology, proving to be an effective salvage therapy in such patients. Systemic taxane-based chemotherapeutic regimens have long been used in several advanced malignancies, and their systemic side effects and associated histologic correlates have been extensively documented...
February 27, 2018: Journal of Cutaneous Pathology
Rumman Ahmed, Konrad Wolfe, Peter Acher, Sidath Liyanage
Granulomatous bacillus Calmette-Guérin (BCG) infection, both localized and disseminated, as a complication of intravesical therapy for transitional cell carcinoma of the bladder is a recognized but highly unusual phenomenon. We report the case of an 89-year-old gentleman with a history of bladder transitional cell carcinoma and subsequent intravesical BCG instillation of the bladder who presented to his general practitioner with a non-tender lump in his left testis. Histopathologic and microbiological evaluation of the subsequent orchidectomy specimen revealed granuloma formation secondary to BCG infection...
December 2017: Radiology Case Reports
Roberto Giulianelli, Barbara Cristina Gentile, Gabriella Mirabile, Luca Albanesi, Paola Tariciotti, Giorgio Rizzo, Maurizio Buscarini, Mauro Vermiglio
INTRODUCTION: Understaging after initial transurethral resection is common in patients with high-risk non muscle infiltrating bladder cancer (NMIBC) and can delay accurate diagnosis and definitive treatment. The rate of upstaging from T1 to T2 disease after repeated transurethral resection ranges from 0 to 28%, although the rate of upstaging may be even higher up to 49% when muscularis propria is absent in the first specimen. A restaging classic transurethral resection of bladder tumour (re-cTURBT) is the better predictor of early stage progression...
December 31, 2017: Archivio Italiano di Urologia, Andrologia
Yusuke Iemura, Shinji Fukui, Yoshiaki Matsumura, Yoriaki Kagebayashi, Yuta Toyoshima, Takeshi Inoue, Shoji Samma
A 69-year-old man received transurethral resection (TUR) ofbladder tumor. The histopathological diagnosis was urothelial carcinoma, high grade, pT1+pTis. The surgical specimens obtained by second TUR showed no residual malignancy histopathologically. Intravesical Bacillus Calmette-Guerin (BCG) instillation therapy was initiated 2 months after the second TUR. He complained of lower abdominal pain and painful urination on the day following the second instillation of BCG. Computed tomography and cystography demonstrated rupture ofthe urinary bladder...
January 2018: Hinyokika Kiyo. Acta Urologica Japonica
Jose Abraão Carneiro Neto, Silvane Braga Santos, Gloria Orge Orge, Davi Tanajura, Lucia Passos, Cassius José Oliveira, Rosana Andrade, Cláudio Galeno de Melo, Ubirajara Barroso, Edgar M Carvalho
AIM: To evaluate the efficacy of the onabotulinum toxin type A in the treatment of HTLV-1 associated overactive bladder and its impact on QoL. METHODS: Case series with 10 patients with overactive bladder refractory to conservative treatment with anticholinergic or physical therapy. They received 200Ui of onabotulinumtoxin type A intravesically and were evaluated by overactive bladder symptoms score (OABSS) and King's Health Questionnaire. RESULTS: The mean (SD) of the age was 52+14...
February 17, 2018: Brazilian Journal of Infectious Diseases
Yosra Selmi, Rania Kheder-Elfekih, Hela Jebali, Lilia Ben Fatma, Wided Smaoui, Madiha Krid, Soumaya Beji, Lamia Rais, Mohamed Karim Zouaghi
Various adverse reactions may occur after intravesical bacillus Calmette-Guérin (BCG) therapy. Although the virulence of attenuated BCG is low, serious complications such as bacterial cystitis, bladder contractures, granulomatous prostatitis, epididymitis, orchitis, and systemic reactions such as fever and malaise have been described. Disseminated granulomatosis such as hepatitis and pneumonitis have also been described, but are rare. We report here the case of a 67-year-old patient who presented with renal granulomatosis with polyangiitis following intravesical BCG therapy for superficial bladder tumor...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Pushpak Bhandari, Gloriia Novikova, Craig J Goergen, Joseph Irudayaraj
New intravesical treatment approaches for bladder cancer are needed as currently approved treatments show several side effects and high tumor recurrence rate. Our study used MB49 murine urothelial carcinoma model to evaluate oxygen encapsulated cellulosic nanobubbles as a novel agent for imaging and ultrasound guided drug delivery. In this study, we show that oxygen nanobubbles (ONB) can be propelled (up to 40 mm/s) and precisely guided in vivo to the tumor by an ultrasound beam. Nanobubble velocity can be controlled by altering the power of the ultrasound Doppler beam, while nanobubble direction can be adjusted to different desired angles by altering the angle of the beam...
February 15, 2018: Scientific Reports
Xinyuan Li, Wuwan Wang, Gongmin Zhu, Weiyang He, Xin Gou
Purpose: Patients frequently undergo radical cystectomy and urinary diversion for treatment of bladder cancer. However, they remain at risk of urethral recurrence (UR). Studies have determined various risk factors leading to urethral recurrence. However, no publications have weighed the predictive values of these factors. Materials and Methods: Studies published between 1971 and 2016 were retrieved from PubMed, EMBASE and MEDLINE. We used STATA software (Version 12...
January 5, 2018: Oncotarget
L Topazio, C Perugia, C De Nunzio, G Gaziev, V Iacovelli, D Bianchi, G Vespasiani, E Finazzi Agrò
BACKGROUND: To investigate the efficacy of tamsulosin in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE) with intravesical prostatic protrusion (IPP). Ultrasound measurement of the IPP has been previously described as an effective instrument for the evaluation of benign prostatic obstruction (BPO) and could help in clarifying the role of alpha-blockers in patients with (BPE). METHODS: Patients with BPE and LUTS were enrolled in this observational study...
February 2, 2018: BMC Urology
Han Jie Lee, Alvin Lee, Hong Hong Huang, Palaniappan Sundaram, Keong Tatt Foo
Objective: Despite high-grade intravesical prostatic protrusion (IPP) being closely related to bladder outlet obstruction (BOO), up to 21% of patients with low IPP remain obstructed. This study evaluates the characteristics and urodynamic findings of men with small prostates and low IPP. Methods: One hundred and fourteen men aged >50 years old with lower urinary tract symptoms (LUTS) were assessed with symptoms, uroflowmetry, serum prostate-specific antigen (PSA), transabdominal ultrasound measurement of prostate volume (PV), IPP and post-void residual urine (PVRU)...
October 2017: Asian Journal of Urology
Lindsey Cox, Chang He, Jack Bevins, J Quentin Clemens, John T Stoffel, Anne P Cameron
INTRODUCTION: This study aimed to determine if gentamicin bladder instillations reduce the rate of symptomatic urinary tract infection (UTI) in neurogenic bladder (NGB) patients on intermittent self-catheterization (ISC) who have recurrent UTIs. Secondary aims were to examine the effects of intravesical gentamicin on the organism resistance patterns. METHODS: We retrospectively reviewed our prospective NGB database. Inclusion criteria were NGB patients performing ISC exclusively for bladder drainage with clinical data available for six months before and six months after initiating prophylactic intravesical gentamicin instillations...
September 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Darren Patrick Moloney, Liam Chawke, Mairead Therese Crowley, Terence M O'Connor
Hypercalcaemia occurs in many granulomatous diseases. Among them, sarcoidosis and tuberculosis are the most common causes. Other causes include berylliosis, coccidioidomycosis, histoplasmosis, Crohn's disease, silicone-induced granulomas, cat-scratch disease, Wegener's granulomatosis and Pneumocystis carinii pneumonia. Hypercalcaemia in granulomatous disease occurs as a consequence of dysregulated production of 1,25-(OH)2 D3 (calcitriol) by activated macrophages in granulomas. Hypercalcaemia in patients with Mycobacterium tuberculosis infection has been reported in 0%-28% of cases...
January 26, 2018: BMJ Case Reports
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